The Mental Aspect of Having Knee Replacement Surgery

By Vickie Wilkerson

3 min read

If you have been reading my articles, then you know I have been trying hard to rehab a broken knee. The incident happened in December 2022. While I am now walking, that knee is not right. When I sit for any length of time and go to get up it feels like that knee is locked in place. It is so painful. I must bend my leg up to make it straighten up where I can walk. While I was trying hard to put off the knee replacement, I now know that I will have to have it done. I was hoping to put it off for at least a couple of years. However, my doctor was right. He said I would come back to him begging to have the knee replacement done. Now I am mentally trying to prepare myself for what lies ahead.

What has my doctor said?

When my doctor first saw the x-ray of my knee, he said that he saw extensive arthritis damage. I told him that made sense seeing as I have psoriatic arthritis. I had already been feeling pain in that knee before the break. He told me that between the break, the extensive arthritis damage, and the meniscus repair in that knee two years ago that a knee replacement would be inevitable in my future. However, he said the good thing about the knee replacement is that I would no longer have to deal with arthritis in that knee ever.

Am I nervous about knee replacement for my psoriatic arthritis?

Mentally I am struggling with the decision. I have spent almost a full year dealing with this knee. I kept hoping it would get better. That somehow it would get back to where it was before the injury. Sadly, that is not the case. Now I must face going through a surgery. Surgeries for me is not a pleasant thought. The anesthesia always makes me sick to my stomach. As soon as I wake up the nausea starts even with them giving me medicine to help. That already fills me with dread.

How do I feel about the physical therapy?

Not easy to accept that I will have to go through physical therapy again. My understanding is that they get you up and walking before you are even released from the hospital. The physical therapist I had when I was allowed to start putting weight on that leg was absolutely amazing. She understood when I told her my psoriatic arthritis was flaring and I was hurting too bad to do much. She said I could request to have her when I have the knee replacement done. My fear is that for whatever reason she will not be able to do it. I fear having a therapist that will not understand the limitations of psoriatic arthritis and he/she will try to push me beyond my capabilities. Maybe I shouldn’t think that way, but it weighs on me.

How long will it take to recover?

This also weighs heavy on my mind. I have already dealt with this for almost a year. What if it takes just as long to recover from the knee replacement? I have heard it can take at least that much time and maybe more. That’s a hard pill to swallow. Mentally I am not prepared for that. While my psoriatic arthritis might not be a problem any longer in that knee it doesn’t mean that it won’t flare in the other areas of my body already affected. That part worries me too. So much mental anguish over something I know must be done.

If you have had knee replacement, would you share some of your tips on how you prepared for it? Was it a mental anguish for you as well leading up to it?

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Mary Lynn Member
 Vickie, a surgery like this, as opposed having your appendix out, absolutely affects a person mentally as well as physically. If I had my appendix out, there likely wouldn't be a lot required of me post op other than good self care while healing. Orthopedic surgeries require us to participate in our recovery with PT. I hope you are able to work with the therapist that you mentioned post op. Because of our arthritis, we are different than the average patient. Too much activity can cause me to flare. One thought I had to help ease the anxiety going in - chunk it. Don't look at the whole picture but take one step (no pun intended) at a time. In short, don't look too far ahead. I do that sometimes and then get overwhelmed. Do you have all of the essentials like a walker and cane? Probably yes because of that horrendous injury you had. A grabber? When I was recovering from femur fracture surgery my sister sent me a walker bag and some darn cute "shoes" for my walker. Purple sneakers that fit on the ends of the walker 😀 Maybe stock up on things you like to do - books, games, movies. Snacks! I was faithful with PT for both knee replacement surgeries and femur fracture surgery. I'm still doing the exercises and walk comfortably, except for a pesky ankle that won't settle down. Know I am wishing you well. I look forward to an update!
LaurenJDK Member
I was diagnosed about 5 and a half years ago with PsA. I had my left knee replaced i Feb. 2022 and my right replaced on Oct. 23, 2023. My advice to you is twofold. First, as the Nike company says, "Just do it." You're stressing yourself needlessly worrying and stewing over the replacement, and worrying/stewing about potential issues that may not be issues for you at all. Nausea from anesthesia? Tell your orthopedic surgeon, the hospital/surgical center and of course, the anesthesiologist. They can administer an anti-nausea med in conjunction with the anesthesia that they use. Ask your surgeon to prescribe anti-nausea meds for you to take at home for 3 to 4 days following the surgery. (Zofran, a.k.a. Ondansetron, is a commonly used anti-nausea med.) Make sure you take your pain meds as specified by your surgeon. Don't play the "I'll see if I can stand the pain without the meds" game - stay ahead of the pain. Second, the key to a successful knee replacement is the physical therapy after surgery. It will hurt - a lot. I won't sugarcoat that. But you must push through the pain and do the exercises. (I think those of us with PsA are, unfortunately, used to pain so are more successful at pushing through it than people who do not live with PsA.) Ask your surgeon if he can order the first two weeks of PT for you to do at home. You'll feel more human after the first two weeks and then you can go to an outside physical therapy facility. Remember, short term pain for long term gain - do the exercises! Once you rehab your new knee you'll be so glad you went through the surgery as you will have a knee that is not continually torturing you. Good luck!
1. Vickie Wilkerson Moderator & Contributor
 <inline-mention username="LaurenJDK" user-id="3296067"/> thank you for all the advice. I will definitely keep it in mind when I do have the knee replacement. I do tell the surgeon and anesthesiologist about it making me sick to my stomach. They do give me something to help with it but it never seems to cover it fully. It does make it better but I would rather not have to deal with it at all. I will have the surgery because I really do not have a choice. I do appreciate your encouragement. Vickie W., Team Member
iwillsurvive Member
Vickie, Please know i have had 2 knee and one hip replacement. When they got me out of bed later after the surgery, i had relief from the pain before surgery. Granted i had incision pain but not the joint pain. I too had meniscus repair, put off the first knee replacement 2 years but was glad when i did. didn't wait for second one to get so bad. About the nausea, you can tell anesthetists that you need something for nausea put in your IV. I hope this helps. Give it to God, He is our Great Physician. 
1. Vickie Wilkerson Moderator & Contributor
 <inline-mention username="iwillsurvive" user-id="3273954"/> thank you for sharing your knee replacement story with me. So far I am only about six months past the initial break healing. Between the healing and how the break happened it has been a long process which is why the mental struggle. I do agree he is our great physician. Vickie W., Team Member